HomeMy WebLinkAboutRevisions 011031ZU17 16:40 All Area Roofing (FAR)772 464 6600 P.0011002
OFFICE USE ONLY:
DATE FILED: /0.) L' PERMIT 4 0 LOW
-
REVISION x)EE: y RECEIPT#
U I T f PLANNING&DEVELOPMENT SERVICES
COUNTY ]BUILDING&COME REGULATIO
2300 VIRGINIA AVE
i.F_ b FORT PIERCE,FL 34982 5
(772)4621553 FAX(772)46 57
EV
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APPLICATION FOR BUILDING PERMU REVISIONS
PROJECT WORMATI.ON
1. LOCATION/SITE
ADDRESS: Acoso _ Llf4 l2 L�L
2. DETAILED DESCRIPTION OF PROJECT
REVISIONS:
Y//.-? GI//,
r d 6 Aj MC,O :jb� �eL,5:5- arean
3. CONTRACTOR INFORMATION:
STATE of FL REG./CERT.#: ? S y LUCIE COUNTY CERT#: ,22090
BUSINESS NAME: 4)1 klml "04
QUALIFIERS NAME:
ADDRESS: AQD J
CTI'Y: STATE: L ZIP:
PHONE(DAYTIME): "7'7 -W �(-�L.�80 @. . .. FAX:
4. OWNERIBUILDER INFORMATION:
NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE: FAX:
5. ARCHITECT/ENGINEER INFORMATION:
NAME:
ADDRIESS: --
CITY: STATE: ZIP:
PHONE(DAYTME): FAX:
Revised 07/22/2014